顽固性高血压患者中原发性醛固酮增多症的患病率:一项回顾性观察研究
Prevalence of primary hyperaldosteronism in resistant hypertension: a retrospective observational study
Douma S, Petidis K, Doumas M | 2009/5/31 18:19:25 |
Lancet | 2008 | View at Publisher
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Background:
Results of several studies published since 1999 suggest that primary hyperaldosteronism (also known as Conn's syndrome) affects more than 10% of people with hypertension; however, such a high prevalence has also been disputed. Experts generally agree that resistant hypertension has the highest prevalence of primary hyperaldosteronism, on the basis of small studies. We aimed to assess the prevalence of primary hyperaldosteronism in a large group of patients with resistant hypertension.
Methods:
Patients with resistant hypertension (blood pressure >140/90mmHg despite a three drug regimen, including a diuretic) who attended our outpatient clinic were assessed for primary hyperaldosteronism. Serum aldosterone and plasma renin activity were determined and their ratio was calculated. Patients with a positive test (ratio >65·16 and aldosterone concentrations >416pmol/L) underwent salt suppression tests with intravenous saline and fludrocortisone. Diagnosis of primary hyperaldosteronism was further confirmed by the response to treatment with spironolactone.